MAY 07, 2019
Correct NDC When Wasting Photrexa Viscous
Question: It is my understanding that Photrexa viscous will not always be used during the procedure. When only the Photrexa is administered, would it be more appropriate to bill with NDC 25357-023-01 with J2787 as that is the more accurate NDC?
Answer: The appropriate coding if Photrexa viscous is not used is to report 1 unit with no modifier and 1 unit with a JW modifier, indicating waste. The drugs are mostly sold as a single use kit which has 2 syringes with 3 ML per syringe - NDC 25357-025-03, which is the NDC on the packaging. The unused Photrexa viscous cannot be used on another patient. If one is not used, it is wasted. Some carriers may request waste reported in other ways, but this is the most common manner. The other NDC code reflects the original packaging when the Photrexa and Photrexa Viscous were sold in separate packages. I believe most insurance carriers now associate the J2787 with the kit NDC so using the old codes may cause reimbursement challenges for some carriers. More information can be found at aao.org/cxl
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